Just days after the presidential election, a Bloomberg headline told the story:

“Trump Puts Hospitals in the ICU.”

To be fair, there is always a difference between a candidate and an elected leader. And on the same day as the Bloomberg story, Trump announced that he would maintain some provisions of the Affordable Care Act.

For example, Trump said he would keep the prohibition on insurers denying coverage for pre-existing conditions, and that he supported allowing young adults to be covered by their parents’ health plans.

Trump made the announcements following his first post-election meeting with President Obama, the first step in the transition to the Trump Administration. Some analysts contend that Trump is moving away from outright repeal of Obamacare and toward a “revise and reform” stance.

That may not sit well with Trump’s constituency, or the Republican Congress. Some 22 million Americans would be without insurance if the law is repealed. And that could spell trouble for hospitals, who have benefitted from more patients with insurance. The Affordable Care Act has meant a boom for hospitals, and repeal means uncertainty in the years ahead. Hospital stocks, which have outperformed the market in the years of the ACA, declined in the wake of the election.

Obamacare accounted for 10 percent of earnings before taxes, depreciation and amortization (EBITDA) last year, and could be more this year. A rollback of Medicaid, a number of hospitals in states where Medicaid has expanded under Obamacare could be hit hard. Bloomberg reported that Quorum Health has more than 68 percent of its beds in Medicaid expansion states. Universal Health has 40 percent of its beds in states where Medicaid has expanded under Obamacare.

Ilene McDonald, in an article for fiercehealthcare.com pointed out that from a political perspective, the newly-empowered Republicans don’t want to see millions of uninsured overnight in the country. The challenge for the new administration is finding a path to transition so that people can stay insured but also access more affordable coverage.

“There will not be a repeal of this without an alternative in place,” lobbyist Michael P. Strazzella told fiercehealthcare.com. Strazzella is with the firm Buchanan, Ingersoll & Rooney. There needs to be a transition to ensure there is no disruption in the market for those covered and the overall market,” Strazzella said. “The healthcare delivery system was all encompassing in this bill.”

At first blush, this means three initial steps in the wake of the election and its unexpected results:

Plan now in anticipation of any and all actions the new administration and the Congress may take.

Time to review business models. As Strazzella put it, “I believe people need to take a hard look at their business models, where they fit into Republican proposals driven by Trump.”

And, hospitals need to push for financial relief from the government for hospitals that already wrestle with narrow margins. Hospitals will need to spend in order to comply with new policies.

While uncertainty swirls for community hospitals in the wake of the election, it’s not a time for panic, but for preparation for any eventuality.

A friend’s son faced what for many kids is almost like a dental rite of passage for teenagers: Braces.

Many of us weathered that ordeal, back in the day when braces gave a smile that looked for all the world like the grill of a ’59 Buick.

The memories are vivid: Elevator music from the speakers, a bland room that had a certain communist Bulgaria feel to it, drab brown and gray, metal and pain, lots of pain. Not to mention that before we even hit the orthodontist’s chair, there was the waiting room. Like expatriates in the movie Casablanca, it’s wait, and wait, and wait.

But the kid in this story had a different tale to tell. Instead of waiting in the waiting room, he was taken straight to the treatment room, where five dental stations were set up, filled with kids getting their treatments, including braces.

The first stop was a tour of the clinic, where staff answered the patient’s questions.

The next was a sink. In a nearby basket, wrapped in plastic were toothbrushes, their bristles covered with an invisible toothpaste. Each kid unwraps the magic tool, brushes his teeth, and tosses the used brush in the trash can.

“That was cool,” the teen said. That’s about as much enthusiasm as you’ll get from a 15-year-old anytime, but especially in dealing with dental matters.

The staff chatted with the teenager, about school, football, the World Series, the same stuff he chatted about with his pals in the cafeteria. Pop music from this decade rocked gently from the speakers.

When all was said and done, the teen was equipped with his new orthodontia. Some metal, some invisible, the new mouth gear still caused pain, and there would be a diet of soup and mac and cheese – soft stuff – for the next few days.

While dentists are much more hip these days in helping patients feel more relaxed, some things don’t change. Pain and braces are paired together like pepperoni and pizza.

The lesson here is that health professionals – doctors, dentists, hospitals, etc., — can make the patient experience more positive by making them feel comfortable and cared for.

Part of that is making the patient feel he or she is part of a team.

For example, one Mobile, Ala., dentist hands out green T-shirts to kids who have their wisdom teeth removed. “I Lost My Smart Mouth,” reads the shirt. A picture of the smiling patient in the shirt is posted on the practice’s Facebook page. A simple, witty shirt makes a tough experience bearable, and even fun.

Imagine your hospital handing out onesies for newborns or T-shirts for other patients, for example, reading “Team Community Hospital.” It’s a cool marketing tool that helps patients and their families feel not so alone.

One Mississippi hospital treats newborn parents to a steak dinner, complete with a rose for the new Mom and sparkling cider.

It’s our mantra when it comes to health care. If it’s good for the patient, it’s good for your practice.

The kid with the new braces, who down the road will have a sparkling new smile, learned that lesson first hand.

In competitive health care markets, being a small community hospital has its disadvantages. But being small can also pack a powerful punch. Physicians and other hospital staffers have higher visibility in small communities. Hometown doctors and nurses are medical “rock stars:” in their communities, acknowledged in the grocery aisle, or the church pew or a youth soccer game.

They’re seen as “one of our own,” in the community and as an expert in their given field. From a marketing standpoint, this gives smaller hospitals a leg up on bigger competitors.

It’s time to, as the kids say, “crank up the jam” for the stars in your hospital or private practice.

In the spirit of the iconic Southern band Lynyrd Skynyrd, here are some ways to “turn it up:”

Create a directory of expert sources: Local media outlets –radio, television, print and online – are interested in health issues because their readers, viewers and listeners are. A media directory outlining each physician, administrator or nurse’s area of expertise can prove an invaluable way to get free exposure for the professional and the hospital.

Keep in mind, there are certain board certifications for nurses – such as a lactation consultant, that can also be invaluable sources for the media.

Don’t be afraid to make your pitch: If a critical health issue – like the Zika virus or opioid addiction – emerges on the state, national or global stage, make media outlets aware that you have experts on staff who can put a “local lens” on these issues. The same is true in the wake of new findings in the literature. Say new research emerges on cholesterol and heart disease emerges in a medical journal, your staff cardiologists and dieticians could be a great news source for reporters and talk shows.

We’ve made the point before, but it bears repeating: Community media outlets hunger for local content to fill their pages and air time. Make a story pitch to the outlets. The worst that can happen is they say “no.” But the best that can happen is free, positive exposure for the hospital. And better, you control the message and your brand gets a boost.

Create a speakers bureau: Civic, church and other community groups are constantly on the lookout for speakers. Your staffers can tell the story of new developments or programs at your hospital. Again, it economically and efficiently builds brand awareness and deepens the community connection.

Train personnel to deal with the media: Every hospital staffer should receive some training in how to deal with the media. Three points: Accentuate the positive. Don’t talk about the competition and keep it simple. Sometimes physicians may get too technical when explaining medicine. Remember, viewers, readers and listeners didn’t go to med school. Keep it at a level that encourages understanding of medical concepts.

The late Texas physician, Dr. “Red” Duke, was one of the earliest physicians to understand the power of television. Seek out a physician who may be willing to do a weekly health segment or Q and A column for local media. Collaboration – or call it “ghostwriting” if you must – can be invaluable in these situations.

Remember: You are the gatekeeper. As a marketing director, you want to communicate a clear, consistent, compelling message. Offer to collaborate with physicians on columns for print and digital publications and offer “talking points” for media interviews or podcasts. And make sure that all media requests, columns, etc. are vetted by the marketing department and higher up the chain of command. Without it, you run a real risk of losing control of the message, which can be dangerous, not only in terms of damaging the brand, but also legal liability.

The year was 1966. My buddy was facing surgery on both legs. He was 9 and suffered from mild cerebral palsy. The surgeon would cut into both legs and extend both heel cords, a procedure that would strengthen his legs and offer more flexibility.

Now 59, my friend’s legs still carry the zipper-like scars from the surgery, now faded from the passage of time. But the memory of it all is still fresh.

“I was scared as hell,” my friend said.

But thanks to three people – a blue-collar surgeon, a blue-eyed nurse and a courageous anesthesiologist, my buddy smiles at the recollection.

The surgeon was the kind of man you’d want on your team in the OR, personable, positive, and confident in his ability. Keep in mind, he was practicing the art of medicine in a blue-collar community hospital. The patients, for the most part, yanked their living from the steel mill and coal mines in the area, or they were the wives and children of those men. The surgeon was beloved, because he took interest in their lives, wanted to know, really know, the families he served.

My friend remembered the anesthesiologist because he told his own story, recounting his family’s exodus from Castro’s Communist Cuba. In these days with the memory of the Missile Crisis still vivid, his courage, kindness and warmth shimmered. And because he was so grateful to be in a free America, he loved his patients, and took pains to make sure every one of them was at ease – even little boys.

And then there was the nurse. These were the days of Tuesday Weld, my buddy’s first celebrity crush. The nurse’s eyes were blue; her hair was blonde – like Tuesday’s.

Once my friend woke up in recovery, the nurse was the first face he saw.

“Did you know I held your hand through the whole thing?” she asked with a smile.

The kid was smitten. And Tuesday Weld was off the throne, replaced by a kind nurse in surgical scrubs.

So, no doubt you’re wondering what the Sam Hill this has to do with hospital marketing.

It’s a simple as this: The surgeon, anesthesiologist and nurse won a little boy’s heart by sharing theirs. And by extension, they captured a family’s heart for the hospital. And they did it using a big dose of something that should be in boundless supply: Genuine kindness. Genuine caring that stretches well beyond the art and science of medicine.

Keep in mind, too, that every hospital employee is an ambassador for your community hospital, not just the ones with the letters M.D., or RN, or CEO. It can be the volunteer at the front desk with an ever-present smile, an orderly who greets every patient he pushes in a wheelchair with a kind word, or the cafeteria worker with a ready smile. Every one can win hearts for your hospital.

Training is important to be sure. But kindness and compassion must be in big supply for every member of your team, from custodian to CEO.

My friend’s surgery was a success and he was able to live a life he never could have imagined, in part because of the surgery, the surgeon, the anesthesiologist and the nurse.

And the hospital was the “family hospital” for generations.

Now keep in mind, not every medical outcome was joyful for the family. Both my friend’s father and grandfather were pronounced dead in the cardiac care unit. When you see a doctor’s tears at sharing the news about a longtime patient, the clinician is showing his heart, and it eases the pain of loss, if only a bit.

The bottom line: Your hospital can win patients’ hearts for generations, simply by showing its own heart.

In 23 years as a physician, Dr. Becky Graham, O.B., has practiced in every setting – hospitalist, urban private practice and health care in rural settings. She’s endured the heartbreak of health system cuts and experienced the excitement of seeing generations of families come to her for care.

Those experiences have honed a fine sense of how to make a practice flourish and some keys to success that transcend strong marketing campaigns. Don’t misunderstand. Marketing is critical, but it’s only one spoke in the wheel of a strong, financially solvent practice.

Some of those spokes are deeply-rooted, timeless attributes, like putting patients first. That’s always been the cornerstone of Graham’s years in medicine. But there are other factors that physicians weighing private practice must consider. When joining a group practice, make sure the group is highly-respected and financially sound. That’s good sense from a marketing perspective.

“From a marketing point of view, nothing is as good as joining a practice with reputable physicians that will funnel you patients and where there are plenty of primary care physicians that will funnel you patients. If you have to depend entirely on marketing, I don’t know if there is a marketing practice that can overcome that.”

While practicing medicine in rural Kansas, Graham’s practice got a big bounce from a billboard, as well as social media. But a billboard in a highly-competitive market may not be worth the higher cost. Graham found success in rural Parsons and Fort Scott, Kan.

“All of it is word of mouth,” Graham said. “When I practiced in rural Kansas, I had a billboard and I got a lot of patients from the billboard.”

“In larger markets, outdoor can be expensive but was more affordable in rural areas. In Parsons, I couldn’t go anywhere without people knowing me, whether they’d been in my practice or not. “(They’d say,) ’Oh, you’re the lady on the billboard. You catch babies for a living.’ It was very effective.”

Look for free opportunities to market your practice. For small-town newspapers, especially in rural areas, a new physician in town is big news. And the space you’ll get from a story and photo is comparable to a print display ad – all without costing a dime. Graham also had success via social media, particularly on Facebook.

Think generationally. Health care is similar to banking in that if possible, children are likely to go to the same physician or hospital as their parents and grandparents – if the physician stays long enough. Or sometimes, the situation is reversed. If a daughter or son like a physician, there’s a real possibility parents and grandparents will come to the practice as well. “It always went one way or the other,” Graham said. “Either the grandma would come and if she liked me then her daughter would come. If she liked me her daughter would come. Or, they would send the teenager in, and if the teen liked me the Mom would come. And if the Mom liked me, then Grandma would come. Yes, I had a lot of families.”

Community visibility counts. Graham also attracted patients by virtue of her faith. As a church worship leader and being active in the Cursillo movement, the community came to know Graham beyond the office. Other civic activities – Rotary, Kiwanis, or volunteer efforts – can also make a difference. By her visibility in various church roles, Graham became “home folks” to the people in the community, a factor that can drive patient loyalty. “I had a lot of patients that came because they knew my faith,” Graham said. I think that’s true in a lot of places. They see a doctor in church, then they know who they are as a person.”

Beyond Facebook: Facebook pages and blogs can be effective, but many times, physicians are swamped with increased paperwork to maintain a blog. There are other technology tools that can boost a practice, like ZocDoc, which provides patients with periodic reminders of upcoming appointments. Graham saw a reduction in the number of no-shows in her practice.

Consider culture: In rural communities and in some immigrant communities, there is a closely-held belief that women should only be seen by female doctors. Graham recalled a Libyan patient who spread word among that community about her practice, attracting more patients. “A lot of times, ethnic or cultural factors would determine who came into my practice.”

And last a reminder: Don’t go it alone: Find good partners with good reputations and solid finances. Shrinking Medicaid and Medicare reimbursements – consider $17 for a wellness visit in rural Kansas – and (depending on the state) rising malpractice premiums – can make the cost of a solo practice, quite challenging.

There are two stories that came to mind recently, stories that pack a powerful health care marketing punch.

First, a friend shared a story from his childhood about his family’s beloved physician. Back in the 1960’s, the doctor –who always addressed parents as “Mother” or “Dad” and gave off a Marcus Welby, M.D. sort of vibe – would write a minimum of two prescriptions for his young patients. One was for the medication, the other for an ice cream cone from the neighborhood pharmacy. (Remember when drug stores had soda fountains? Some, thankfully still do).

As you might guess, the ice cream prescription also virtually guaranteed the other script would be filled at the neighborhood pharmacy, too.

Sadly, Big Pharma put the kibosh on such practices, but my friend’s family doctor will always be remembered for his gentle, caring bedside manner, and ice cream, qualities that endeared him to families, earning their trust for generations.

The second story involves – at least indirectly — arguably the greatest athlete of the past half-century, Bo Jackson. In Pensacola, Fla., The Andrews Institute practices world-class sports medicine. The institute’s founder, Dr. James Andrews, is recognized as one of the best orthopedic surgeons in the world, a man who has resurrected or prolonged the careers of many athletes, including Jack Nicklaus, Michael Jordan and yes, Bo Jackson.

But the Andrews story is about more than marquee athletes. Last year, a friend’s oldest son, then 13, wanted to try out for the high school basketball team, which required a physical. On a certain Saturday in August, the Andrews Institute offered free sports physicals for the young athletes. These were thorough examinations. My friend watched his son as he moved from station to station, the walls adorned with photos of some of the world’s best athletes, all of whom had received care from the Andrews Institute.

As each youngster viewed a new photo, their eyes would grow large and they would talk excitedly to the next kid in line. The idea that the medical practice that had cared for Bo and Michael “His Airness” Jordan was not lost on the kids of the ESPN and video game generation. During the examination, they were like Bo and like Mike, at least for a little while.

As each young athlete completed his or her physical, they were given snacks and a T-shirt.

My friend’s son beamed as he left the clinic.

What’s the marketing lesson of ice cream cones and Bo Jackson?

Flashy marketing campaigns can reap big benefits for community hospitals. But giving can be just as powerful, creating brand loyalty for generations.

There’s a tearjerker scene near the end of the film Forrest Gump. Following the death of his beloved Jenny, Forrest ponders the meaning of life in his simple, yet wise way:

“I don’t know if we each have a destiny, or if we’re all just floatin’ around accidental-like on a breeze. But I, I think maybe it’s both.”

As healthcare marketers, there’s a question we need to answer: Are we marketing for consumers, or for physicians?

To borrow from Forrest: Maybe it’s both.

But truth be told, marketing to physicians and telling your story to patients are two different things, though there is some overlap.

Let’s first ponder the physician question. Any hospital, large or small, wants the finest medical staff it can get, from the hospitalist to the physician in private practice.

In a sense, attracting staff physicians is a great deal like a courtship. Both engage in a “getting to know you” dance, to learn if the match is a good fit. And that match includes everything, the surrounding community, the hospital itself and the staff. That’s why hospital recruiters give prospects a dose of the hospital and a dose of the town. If a physician has a family, schools are critical as is overall quality of life.

And, those same physicians want to see quality from the hospital, in staff, in facilities, in patient care, in external marketing and in long-term vision.

The same concerns exist for physicians in private practice, along with the prospects for profitability.

Keep in mind, the physicians in private practice play a big role in your patient population. If that doctor has privileges at your hospital, he will perform his services there. And if the doctor trusts the hospital, chances are, his/her patient will as well. And it’s the start of a potentially long-term relationship.

Remember too, the physician’s professional reputation can be affected by the hospital, and vice versa.

It’s a low-key kind of marketing.

But what about the patient piece of the pie?

As we mentioned, the physician plays a key role. And so does word-of-mouth. We’re firm believers in the late marketing guru Zig Ziglar’s “Rule of 250.” It’s the idea that every person knows at least 250 others –family, friends, colleagues and acquaintances. (However, given the advent of social media, that number is larger. According to the Pew Research Center, the average number of Facebook friends for adults in the United States is 338).

A good word of mouth from a relative or friend does as much or more than a well-placed, effective ad. If Uncle Joe or Aunt Martha has a good experience at Kildare Community, chances are you’ll go there, too, but if the reverse is true, consumers will run fast and far.

For community hospitals on a budget, social media is vital because of its efficiency, cost effectiveness and reach. And, using traditional media to tell your hospital’s story can also be invaluable to attract patients.

In small communities where everyone knows everyone it seems, hospital employees can be effective marketers. That’s why bringing the entire team into the marketing mix is vital.

But marketing to both physicians and consumers is critical, where the health care market is competitive. As the world shrinks, that’s every market. Small-town medical centers have to compete with larger hospitals with larger marketing budgets in nearby larger cities.

The diagnosis: When it comes to the question of marketing to physicians or consumers, remember Forrest Gump: It’s both.